Abstract
Malreduced syndesmotic injuries lead to poor outcomes. No consensus exists regarding
preferred surgical treatment. This study aims to assess clinical and radiographic
outcomes in patients undergoing distal tibiofibular arthrodesis or stabilization.
Retrospective review identified patients undergoing distal tibiofibular arthrodesis
or stabilization between 2003 and 2019. Surgical factors, revision surgeries, and
American Orthopedic Foot and Ankle Score ankle-hindfoot scores were collected. Radiographs
were independently evaluated by 4 surgeons. Seventy patients were included. Mean American
Orthopedic Foot and Ankle Score scores (n = 33) improved from 48 ± 16 preoperatively to 85 ± 14 (p < .001) at a median follow-up of 31.1 months. Mean Kellgren scores (n = 47) increased
from 2.1 ± 1 to 2.5 ± 1 (p < .001) and the mean medial clear space decreased from 3.2 mm ± 0.8 mm to 2.8 mm
± 0.8 mm (p <.001) with no differences between the arthrodesis and stabilization groups. Zero
patients progressed to arthroplasty or fusion. Patients demonstrated significant functional
improvement after distal tibiofibular arthrodesis and stabilization. Progression of
arthritis, while statistically significant, was not clinically significant.
Level of Clinical Evidence
Keywords
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Article info
Publication history
Published online: June 27, 2022
Footnotes
Financial Disclosure: None reported.
Conflict of Interest: Jason Strelzow, MD is a consultant for Acumed, Synthes, BoneSupport and has received nonfinancial support from Stryker. The other authors have nothing to disclose.
Identification
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© 2022 by the American College of Foot and Ankle Surgeons. All rights reserved.
